PROBLEM SOLVING IN CLINICAL PRACTICE
The importance of re-evaluation, re-investigation and follow-up of adrenal insufficiency
Department of Paediatric Endocrinology, Southampton University Hospital, Southampton, UK
Correspondence to:
For correspondence:
Dr J H Davies
Department of Paediatric Endocrinology, Southampton University Hospital, Tremona Road, Southampton SO16 6YD, UK; justin.davies@suht.swest.nhs.uk
| The first 150 words of the full text of this article appear below. |
Gareth was born in 1982 as a normal delivery at term, birth weight 2.92 kg, and had normal Apgar scores following an uneventful pregnancy. Five hours after delivery he was hypothermic and was found to have a blood glucose of 1.0 mmol/l. The hypoglycaemia resolved with continuous nasogastric feeds followed by three-hourly bottle feeds. He was discharged from hospital three days later.
At 5 weeks of age he presented to his general practitioner (GP) with an eight-hour history of episodes of floppiness associated with a dusky complexion. There had been a one-week preceding history of coryzal illness and a cough with intermittent episodes of cyanosis. In the preceding weeks there had been poor weight gain, he had been slow to feed and had occasional non-projectile vomiting. The GP suggested that the most likely diagnosis was a viral upper respiratory tract infection but, given the history, he arranged for the baby
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